Parenting and Family

Every family is unique, with different family dynamics, as well as cultural, social, and religious influences. Learn more about how these influences can affect the children in your life.

Understanding Children’s Gender

Gender is more complex than most of us have been taught. Gender is made up of three parts: (1) gender biology (our bodies or biological sex – our sex assigned at birth based on appearance of genitals), (2) gender expression (how we dress and act), and (3) gender identity (how we feel inside). For most kids, these three facets of gender line up and the kids are typically gendered boys or girls (cisgender). For other kids, however, these three facets of gender align differently; these kids are gender-expansive, which includes transgender kids.

Although our society teaches us that there are only two genders—male and female—there are really many genders. Not all children fit neatly into a male or female gender identity. For some children, the sense of being “both” or “neither” best describes their reality. Some of these kids speak of being more of one some days and more of the other on different days; these children might best be described as gender fluid. These are all normal variations in human gender and do not mean something is wrong with a child. A child’s gender is not what others tell them, but who they know themselves to be.

Even though we as parents have great influence over our children, parents can’t change a child’s true gender identity or expressions of their gender. However, we can help our children to have a healthy, positive sense of themselves in relation to their gender.

What Do We Mean by “Parenting and Family”?

When we talk about “family,” we are not referring only to people related by genetics. Families can come in all configurations, including adoptive or foster parents, grandparents, extended family, mentors, or one’s chosen family made up of close friends. Many youth have been rejected by their genetic and adoptive families and need support from other adults. Similarly, “parenting” can be done by a variety of adults in a child’s life, not just by legal parents or guardians. Thus our resources in this section, and in our work in general, are for all types of “family” and all adults who “parent” a child.

General Parenting Considerations

Parents have a very powerful role to play in a gender-expansive youth’s life. Research has shown that supportive parenting can significantly affect our children’s positive outlook on their lives, their mental health and their self-esteem. On the other hand, rejecting parenting practices are directly correlated to gender-expansive and transgender youth being more depressed and suicidal. Research shows that the most crucial thing we as parents can do is to allow our children to be exactly who they are.

Every family is unique, with different family dynamics, as well as cultural, social, and religious influences. Some families have to consider their child’s physical safety in their communities more than others, but all families have to weigh the effects of their parenting approach on their child’s long term psychological well-being.

What are Affirming Parenting Practices?

Parenting practices that are based on affirming a child’s own sense of gender strengthen a child’s self-esteem and sense of self worth. While some of the parenting practices discussed in this section may be challenging for some parents to implement, it is important to take whatever steps you can to demonstrate to your child that you are with them on this journey.

Create a supportive family environment: The ability to make the home a sanctuary of security and support for your child is the single most important factor in promoting lifelong health and well- being for your child. Such an environment creates a buffer for your child from the hardships they may face outside of the home. Creating such a space may not come easily for you, particularly if you are struggling with accepting your child’s gender identity or expression. If so, seek help from an empathetic, knowledgeable friend, family member, support group, therapist or other source of support.

Require respect within the family: With immediate and extended family, it is imperative that you require and accept only kindness and respect for your child. While you may not be able to change people’s opinions, you can certainly dictate how you expect others to behave and speak around you and your child. It can be scary to make this demand of family members, yet many parents report that once they’ve taken a stand on their child’s behalf, they feel a great sense of relief and empowerment.

Express love and support for your child’s gender expression: What does this look like? It means allowing them to choose, without pressure or unspoken messages, the clothes they wish to wear, how and with whom they play, their favorite toys, the accessories they favor, the manner in which they wear their hair, and the decorations and images with which they surround themselves. It means helping them prepare for any negative reactions they may encounter outside the home by practicing their responses with them and making sure, when appropriate, that there is a safe adult for them to turn to in case they need assistance. It means discussing any negative or conflicting feelings you are struggling with over their gender identity or expression with other adults, not with your child.

Allow zero tolerance for disrespect, negative comments or pressure: A concrete way to demonstrate ongoing support and acceptance for your child is to tolerate absolutely no negative comments about your child, from anyone, whether your child is with you or not. This means following up with the people who make such comments in a firm way that makes clear your commitment to your child’s well-being. It may also mean needing to follow up with other parents or the school about the comments made by other parents or children.

Maintain open and honest communication with your child: Stay open about this journey, both your child’s, and your own. By demonstrating to them that you are a partner in this process, and showing a genuine sense of interest in how they see themselves, what they think, what they are experiencing, you show that you are there for them. This open level of communication will also help you evaluate your child’s level of stress or distress, and whether they may need additional outside support or intervention.

What are Unaffirming Parenting Practices?

When their authentic sense of self is not recognized and affirmed, it undermines a child’s self-esteem and feelings of self-worth. It should not be surprising that many children who end up in the foster care system, run away, or become homeless are gender-expansive and transgender; rejected at home, they find themselves with few options for support. Refusing to accept one’s child as they are and behaving in an unkind, punitive, or disrespectful manner communicates to your child a lack of value or worth.

As you read the list of behaviors below, try to also have compassion toward yourself. Many parents have employed these practices at one time or another. What is important is to commit to communicate your love and support for your child from this point forward. We can only start from where we are.

Physical or verbal abuse: One of the most damaging things you can do is verbally or physically abuse your child. It won’t get them to change, and it places them at a far greater risk of suicide. Even if you have the feelings internally, work to keep them there, rather than outwardly demonstrating your struggle to your child.

Exclusion from family activities: The urge to avoid being embarrassed by your gender-expansive child may not seem blatant to you, but it sends a message of shame and implies core change is required in order to be a member of the family. Insisting your child “dress properly” or “act normally” makes your child feel that the comfort of others trumps their own sense of well-being and security.

Blocking access to supportive friends or activities: Preventing your child from seeing gender-expansive friends and allies or participating in supportive activities will only generate a sense of isolation and significantly increase risk factors. Blocking your child’s access not only cuts them off from a critical support system, it also stigmatizes other people like your child.

Blaming the child for the discrimination they face: Saying that a child deserves any mistreatment that they encounter simply for being who they are is incredibly dangerous, an implicit message that they are to blame for the cruelty of others.

Denigration and ridicule: When you speak or treat your child with disrespect, or allow others to, it shows them that they cannot count on you for the love and protection they desperately need.

Religious or faith-based condemnation: Telling a child that God will punish them greatly increases health and mental health risks, and can remove a vital source of solace.

Distress, denial, and shame: When a child sees that they are causing you great distress and shame, they internalize this pressure. It is damaging to openly communicate your denial of their gender identity or expression.

Silence and secrecy: Insisting your child remain silent about their gender identity or expression tells them that there is something inherently wrong them. If you are keeping your child’s gender identity or expression a secret because you are worried about their safety, think about ways you can balance keeping your child safe with your safety concerns while still letting them know that you support them (see Safety Considerations below).

Pressure to enforce gender conformity: Even when motivated by a desire to protect your child, asking them to mask who they are sends the harmful message that there is something fundamentally wrong with them.

How Do I Know if This is Just a Phase?

For some children, expressing gender-expansiveness may be a phase; for others, it is not. Only time will tell. We suggest using the concept of insistence, consistence and persistence to help determine if a child is truly gender-expansive or transgender.

If a boy likes to play with dolls or likes the color pink, this doesn’t mean they will grow up to be transgender. If a girl wants to be called “John” for a couple of weeks, this doesn’t mean she will always feel like a boy. The longer and more insistently that a child has identified as the opposite gender, a combination of genders, or neither gender, the easier it becomes for a parent to know. Regardless of the eventual outcome, the self-esteem, mental well-being, and overall health of a child relies heavily on receiving love, support and compassion from their parents no matter where they are on their gender path.

Young Children

If your child has identified as the opposite gender since early childhood, it is unlikely they will change their mind. Most people have some sense of their gender identity between the ages of two and four years old. For most, this awareness remains stable over time. For example, a 12 year old child who was assigned a male gender at birth, but has consistently asserted “I am a girl” since the age of three, will most likely remain transgender throughout life.

There are cases when a young child who strongly identifies with the opposite gender does change their mind. The most common time for this to occur is about 9-10 years old. There is insufficient research to know if these children later identify as gender-expansive or transgender adults. So, it is unclear if this change indicates that the child has learned to hide their true self, or if it was indeed just a childhood phase.

Teens

Another typical time for gender identity to come into question is at puberty. Many teens who have never exhibited anything outside the norm in their gender expression or identity, start feeling differently as puberty approaches. This can be very confusing for parents who “didn’t see this coming.” Since adolescence is a time of exploration and change in general, it can be hard for parents to know if this is just a teenage phase, or whether their child is “really” gender-expansive or transgender. Again, look to the concept of insistence, consistence and persistence to determine if a child is truly gender-expansive or transgender. This may mean you won’t have an answer for quite a long time.

Though these are two common times for gender identity to come up for children, they are certainly not the only times. A child at any age, even to adulthood, can start feeling differently about their gender identity or expression.

What About My Feelings?

Parents have a variety of responses to their gender-expansive or transgender children, and none of them are “right” or “wrong.” Feelings of embarrassment, denial, anger, fear, doubt, grief, and worry are normal, as are feelings of acceptance, understanding, support, pride and joy. Many parents feel a combination of positive and negative feelings. This is a hard road for parents, and even though we may not have chosen this for our child or ourselves, it is our road to navigate. You are not alone in your feelings or in your experience of raising a gender-expansive child. It can be very helpful and comforting to seek support from other parents or from a mental health professional.

Feelings of guilt

It is common for parents to blame themselves when a child falls outside of gender norms. They ask themselves, “Is it my fault somehow?” “Where did I go wrong?” Mothers may feel they were too permissive. Fathers may be angry and refuse to accept their gender-expansive child, especially if this child was born a boy.

Current research supports the theory that gender is “hard-wired” in the brain from birth. Gender diversity is not an illness or a result of poor parenting. It is not the result of divorce or an indication of child abuse. Gender diversity is not caused by liberal, or permissive parenting, or by a parent who secretly wished their child were the ‘opposite’ sex. It is normal. You did not cause this or do anything wrong.

Feelings of loss

Another common feeling is that of loss. Families, parents, and siblings may feel a sense of grief at the idea they are “losing” their son or daughter, their brother or sister. Even though the child is alive and well, a socially recognized gender change can elicit strong feelings of losing the person we thought we knew. We may experience periods of sadness, anger, and mourning as we (or our other children) come to terms with our child’s authentic identity.

Living with uncertainty

One of the biggest challenges to raising gender-expansive kids is learning to live with uncertainty. When a child is not clearly identifying as male or female, even parents who want to be supportive can find themselves thinking, “(j)ust decide already, one way or another!” A lack of consistency in their child’s gender expression can leave parents wondering just who their child “really” is. Parents feel more empowered to help their child if they know where their child will end up.

Gender identity is not always “one or the other.” We need to recognize that not every child is on the path to choosing a male or female gender identity. Many children (and adults) feel like they are both genders, neither gender, or go back and forth. They have already arrived at their final destination, which is a space outside typical gender constructs. Or, they may still be figuring it out. We won’t know until our child knows and can communicate this to us, and that may take many years. It is important for us to follow their lead, and let them figure out who they are at their own pace.

Finding language that works for your child and yourself can be a big help in dealing with uncertainty. With older children, this can mean discussing together how they would like for you to refer to them, both directly as well as when you are speaking with others. Some families take the approach of working around pronouns by just using the child’s name. Others use gender neutral pronouns such as “they” or “ze.” Developing stock responses that don’t include male or female pronouns can also be helpful: “My kid is just being their true self!”

Examining Our Own Gender Stories

Everyone has a gender story, including us parents. Every person in our society has been affected by gender norms, either positively or negatively, in their lives. If we make our gender stories part of our family conversations, then gender identity and expression becomes about all of us, not just about the one child who is “different.”

Gender norms and expectations are different now than when we were growing up and will continue to change. Many teens and young adults today define their genders in ways we didn’t even know existed. It is important for parents to accept this new frontier of gender identity and gender expression and to take the time to think about how our children’s experiences relate to our own experiences growing up. What assumptions do we make about gender based on how we were raised and the messages we received? Are these the only way to think about gender? How have gender norms affected us in ways we do or don’t want them to affect our kids? These exercises will help us in understanding our child’s gender story, as well as our own, which can only help us be better parents.

Supporting All of the Children in the Family

Sometimes the gender diversity of a family member can create a sense of perpetual crisis in a family. Because of society’s discomfort with gender diversity, we may unconsciously bond with our cisgender children more than our gender-expansive child. By doing this, we may inadvertently place siblings in a position of choosing loyalties to us or to their gender-expansive sibling. Alternately, we may focus on the exceptional needs of a gender-expansive child, overlooking the sibling as a result.

A sibling may act out in an effort to gain our attention, possibly in ways that are hurtful to their gender-expansive sibling. For example, the sibling may “out” or disclose personal information about the gender-expansive sibling at inappropriate times or in a disrespectful manner.

Gender diverse children may be teased and bullied, even by their siblings. Siblings may participate because they feel pressure from their peers to ostracize or be critical of their gender-expansive sibling. On the other hand, siblings often feel obliged to defend their gender-expansive sibling from bullying by others. Siblings may be teased and bullied themselves.

One strategy to avoid the division between gender-expansive kids and their siblings is to make sure we discuss gender as it relates to all people (see Examining Our Own Gender Stories above). This not only avoids treating the gender-expansive child as if they are the “problem,” but also helps support siblings in their experiences as well.

Talking with Extended Family and Friends

It can be nerve-wracking and scary to bring up the topic of our child’s gender with family and friends. Even if our closest friends and immediate family members are aware of our child’s gender expression and identity, it may be hard to see people that either didn’t previously know about our child’s gender, and may not be supportive.

There is not just one way to deal with this situation, of course, as every family and group of friends are different. Remember that family members and friends are at different places in their understanding of gender identity and gender expression; recognize that while we’ve had some time to think about this (and think about it, and think about it…), this may be completely new to them, as it was to us at some point in time. They also aren’t around our children as much as we are, and may not see what we see in our kids.

One strategy is to call or write to family and friends before seeing them. Let them know about your child’s gender and that you are fully supportive of your child. Of course, it’s natural for them to have questions; let them know they are welcome to ask you anything in private, but they should not talk about it in front of your child. Let them know that regardless of their personal feelings about your child’s gender and/or your parenting choices, that you expect them to be kind and respectful to your child. We have collected some sample letters that parents/caregivers have sent to family members and friends to assist you in this communication.

Spend some time identifying your expectations, then be very explicit about what you are requesting of them. For example, you’d like them to use your child’s preferred pronoun and name; you’d like them to avoid negative comments about their hair, clothes, toys, etc. If presents are being exchanged, you’d like them to give what your child actually wants to play with and not what they think your child should play with.

Remind your family and friends that your child is more than just their gender and they should see and relate to your whole child. If they are nervous, tell them what your child’s current interests are so they will have some safe topics to discuss. Direct them to the Gender Spectrum website, or offer some articles or books for them to read so they can learn more about gender-expansive kids. The Transgender Child is a good primer on the topic. Share articles that explain gender and kids so you don’t have to be the expert.

The more you learn to speak with confidence and pride about your child, the easier it will be for others to accept your child and your parenting. People look to you for their lead on how to respond or react to your child. You have nothing to apologize or be ashamed about. Remember, it’s your job to take care of your child, not the needs of other adults. A desire to help other people feel comfortable is natural. Yet if you find yourself doing so by denying or dismissing your child’s authentic self, it can be quite hurtful. For example, if an acquaintance or new person you meet asks about your dress-wearing boy, rather than making comments such as, “Oh yes, that is my son. He’s just pretending to be a princess today,” consider simply saying, “Yes, that’s my son,” or even “Isn’t it great that he’s not afraid to be himself.” Your priority is your child’s well-being.

Privacy Considerations

Raising gender-expansive and transgender kids comes with constant decisions about when and how to share information. Each situation and each family is different. Some kids are completely open and tell everyone they meet about their gender, while others don’t ever want to mention the word “gender.” Some gender-expansive and transgender kids conform to societal norms of gender expression, while others are so clearly a combination of genders, that there is no option of being private.

Are you obligated to disclose if your child is going on a playdate? What if they are sleeping over at a friend’s house? Going to a school dance? A school overnight trip? In fact, there are no rules about when you must share information about your child. What type of body your child has is no one else’s business. Other people don’t have to tell us what’s in their child’s pants, why do we have to tell them what’s in our child’s pants? The only considerations we need to think about are what’s best for our child in each situation.

Remember that once you share your child’s gender information, you can’t un-share it. Even if a child is OK with being open when they are little, their needs around privacy may change as they grow older.

For additional information on privacy considerations, we encourage you to visit our Resources section.

Safety Considerations

Children not fitting into typical gender boxes are often the victims of mistreatment or even violence. Caregivers to gender-expansive children bear a burden to ensure the physical and emotional safety of these kids in the face of that general reality.

Our role as parents is to love and accept our child, and we will help them learn how to deal with a world that sometimes doesn’t understand them. Without alarming them, we can help prepare our children for unwanted questions or comments by helping them come up with respectful replies that maintain their boundaries; this way, they won’t be left on their own to come up with a response on the spot.

We also need to teach our children how to access the support they need if it feels like things are becoming unsafe. We each know our own communities best, so we each need to decide if our children are in physical danger by expressing their gender in public, and weigh this physical danger against the emotional harm of not allowing our child to be their true selves outside of the home.

This can be tricky territory- our own discomfort, as well as a desire to protect our children, may lead us to decide to allow one set of behaviors in the home, and another set outside the home. But there is a cost to this choice: to your child’s sense of self, and potentially their experience of your support and acceptance.

There are a number of safety considerations for you to consider – remembering to place your child’s needs at the forefront of your decision making process is the first step to protecting them.

Transitioning

When a person changes outwardly from one gender to another and lives in accordance with their gender identity, it is called going through transition, or transitioning. Transition can occur in two ways: social transition through non-permanent changes in clothing, hairstyle, name and/or pronouns, and medical transition through the use of medicines and/or surgeries to promote gender based body changes..

There is no rule of thumb for when a transgender child should be allowed to transition socially and/or medically. There usually comes a time when your child’s discomfort or suffering is so obvious that despite your concerns, it is critical for them to live in the world as they choose. But how do you know when that is? How long after they tell you about their desire should you wait to allow them this form of expression?

In making this decision, two concerns typically rise to the surface: “Will my child be safe if I let them do this?” and “Wouldn’t it be better just to make them wait?” The most useful way to answer these questions is to first evaluate whether your child currently feels safe and satisfied, or if instead they are suffering. If your child is suffering it is important to weigh the potential dangers that await them if they were to transition, compared to the dangers associated with their current depression.   What is clear is that children who receive the support of their families have the best outcomes in terms of their future health and well-being.

Navigating Religious Communities

Depending on the religion or religious community, acceptance of gender diversity can vary tremendously. It can be helpful to take stock of your religious community’s influences. List the overt messages and messengers about gender and sexual orientation issues, as well as how LGBT people tend to be characterized. You might be able to identify people who you perceive as “safe.” Approach these members first about your situation and seek their counsel on how to approach others.

It is also important to remember that gender diversity cuts across all racial, cultural and religious lines. With sensitive exploration, you may find people in your religious community who are more tolerant than others. Some people find they can educate their present religious community about gender. Other families find they need to seek new religious communities that are more welcoming of their family. In the process of supporting your child, you may well lose important people in your life, but more than likely you will also gain some important new people to replace them.

School Considerations

Choosing a School or College

Choosing a school or college with our kids is an important decision. Talk to the administrators or admissions staff about gender diversity to determine if the school will be a good fit for your child. For a more in depth assessment on choosing a school or college, please visit our Resources section.

Working with the School

Forming a positive relationship with school administrators and staff, whether you are new to a school or returning, it vital to the safety and success of your gender-expansive child. You will need to be proactive. You cannot assume that schools with general anti-bullying policies will be responsive to the needs of your child. Be sure to approach the school as partners, not as adversaries. Assume they have positive intentions; the vast majority of educators are interested in the well-being of the students and families they serve. However, most have little or no training about working with gender-expansive children. It may be that you will need to help them by providing resources, materials, and examples of other schools that have successfully met the needs of gender-expansive students.

Most schools have written or unwritten aspirations around inclusion and diversity; bring these into your discussions to show you want what is best for the whole school community. You may be hopefully working with these teachers and administrators for many years, and not only around issues of gender, so the goal is to forge a positive collaboration. You can use our outline, “Initial School Meeting” as a guide.

Even before your child starts at a school, you can start preparing. Many schools do professional development during the few weeks before school starts. Ask for gender training to be included in this professional development, so teachers feel prepared to deal with your gender-expansive or transgender child. Even if you are the first family at the school with a gender-expansive child, you certainly won’t be the last. Point out that it is in the best interest of all of the students, not just your student, for the staff to be trained, as gender affects every child and the school wants to create a gender-inclusive environment. The good news is that resources exist to help educate schools, including our own Gender Spectrum Trainings.

Safety in School

It is well documented that a safe environment optimizes a child’s ability to learn. A child cannot effectively learn when they live in fear of discrimination. All children, including gender-expansive and transgender children, deserve a safe school environment, free from bullying, teasing and violence, and it is the school’s legal responsibility to maintain that environment. Your child’s gender identity or gender expression in no way excuses mistreatment by other students, staff or parents. While it is important to work in partnership with the school, your child’s physical safety  and emotional well-being are non-negotiable. School districts and individual school administrators can be held liable under various federal, state and local laws for failing to protect students from harassment based on gender identity. From the beginning, if you believe your child is being mistreated based on gender, document those concerns and share them with the school leader. Make it clear that while you wish to work with the school, you will take whatever steps necessary to keep your child safe.

If you’ve tried to work with the school and they are unresponsive or unreasonable, you may need legal advice (see Legal Considerations).

Bullying in School

Bullying is a serious problem for any student. Most schools recognize this fact, and many are adopting programs and policies to create environments that do not allow or tolerate bullying. Bullying can take the form of one or more students directly teasing, taunting, or threatening another. Bullying comes in other, more indirect forms as well. A student may experience intentional social isolation perpetrated by their peers, and sometimes even reinforced by teachers and/or the administration.

Often, bullying is related to gender expression, even if on the surface it appears to be motivated by something else. For instance, a boy may be taunted as “gay,” not because he is in fact gay, but because his gender expression falls outside the society’s norms of masculinity. Your school may not specifically name gender expression or gender identity as reasons for bullying, but it does not mean that they will not respond proactively. Further education about gender diversity is often needed for teachers and school administrators to respond most effectively.

Other School Issues

Along with a child’s general safety and well-being, there are several specific areas that will require your attention. These include how your child will be referred to (name and pronouns), and listed on school records, how your child’s privacy will be protected, will you child be allowed to use the restroom and locker room aligned with their gender identity, and participation in overnight trips, sports or clubs.

As students get older, they must navigate school dance, crushes, and gossip. Talking about these situations ahead of time with your child will help them be prepared.

Our “Gender Support Plan” is a great tool to help you in these discussions with your school. This resource, as well as many others, can be found in the Resources section of this website.

Camps, Sports Leagues, and Other Out-of-School Activities

Many of the same situations that arise in school situations arise in out-of-school activities as well, such as privacy considerations, restrooms and locker rooms, and overnight sleeping arrangements.

Just as with schools, most adults who run these activities have no experience with gender-expansive or transgender kids.

Sometimes, camp or outside activities are opportunities for gender-expansive kids to see what it is like to present as the opposite gender, if they are not already doing so at home and at school.

Depending upon what documentation you need to register your child, you can think about registering them as their preferred gender. If you don’t have documentation, look into obtaining a state I.D. to use instead of a birth certificate, as in some states it is much easier to change a gender marker in the state system than it is on a birth certificate.

Some families choose to be completely open with camps and activities about their child’s gender and some don’t share any information at all. Another approach is to tell only the camp leader(s) and ask them not to disclose this private information to staff or campers. If you do choose to share your child’s gender information, take the same approach with camp staff and coaches as with schools—assume positive intent and work to educate their staff. Proactively speak with the camp leaders about potential issues before they arise, and ask if they are willing to have their staff receive gender training.

Medical Considerations

Changing bodies to match gender identity

Gender-expansive and transgender kids do not have to change their bodies in order to change their gender expression or identity. Some choose to make no changes to their bodies at all, while others know that they must change their bodies to feel complete. One of our roles as parents is to help our children figure out what road is right for them.

Keep the lines of communication open and explore options together. Discussing what you learn together can work to make the whole family better informed as well as allow for ample adjustment time. However, keep in mind that a parent and child may have very different ideas of an appropriate timetable. Don’t feel rushed into making decisions about permanent changes, but also keep in mind that your child may feel rejected by you if these critical life decisions are delayed indefinitely.

Children’s emotions around medical care

For many kids, going to the doctor can be traumatic. For gender-expansive or transgender kids, physical examinations of their bodies can feel especially invasive because if forces them to face a body they want to be different. Or, it can feel hard to explain their gender expression to a doctor who doesn’t understand.

Choosing Medical Professionals

It is important to find a medical professional who understands children and gender, or who is at least willing to educate themselves. Interview potential medical providers and find out about their experience in working with gender-expansive or transgender children. Ask about how they see their role in your child’s gender journey, and make sure they won’t be another adult trying to put your child into a gender box.

If your child is going down the road of physical transition, you don’t have to only work with an endocrinologist. Any physician, including your pediatrician or family practitioner, can help a child with start their physical transition with hormone “blockers” and/or cross-hormones.

If no one in your area is qualified, try to find someone who is willing to learn. We can help connect them to experienced physicians who can consult with them about the process. Unfortunately, many physicians are intimidated by this relatively new area of practice, or disagree with treating transgender children. Sometimes, families end up having to travel to established gender clinics in order to receive treatment for their child.

As with any relationship with a medical professional, it is important to be an active participant in your child’s care and monitor the physician-client relationship on an ongoing basis.

Need some help finding a medical professional? Gender Spectrum has connections to many professionals who are committed to affirmative care and support of gender diverse youth. If you need referrals for medical, mental health, legal or educational support, contact us at and we will connect you to professionals who can help you find appropriate referrals.

Mental Health Considerations

Should We Seek Mental Health Support?

Children who fall outside of typical gender norms don’t automatically need to see a therapist. Gender diversity is not a mental illness that needs to be treated. If your child is generally content and functioning like most other children their age, they don’t need to be in therapy. On the other hand, if your child is depressed, anxious, or distressed due to their experience of their gender or due to other peoples’ reactions to their gender identity and expression, then they may need some extra support.

Raising a gender-expansive child is complicated in a world that doesn’t yet understand gender diversity. The constant decisions—large and small—we need to make can be exhausting. Should my child wear that outfit to school? Should I tell this person before we get together with them? Should I correct people if they assume my child is a different gender than they identify with? Will my child be safe and supported at school? The pressure to be an expert on gender and kids can feel overwhelming. Because of this, oftentimes parents will seek therapy for themselves in order to gain some support around parenting issues related to their child’s gender.

Whether you seek professional help or not, it is important to keep the lines of communication open between you and your child around gender issues. Talk about your own experiences with gender norms so your child understands that everyone has a gender story, not just gender-expansive people. If it’s not already part of your pattern, try to raise the issue of gender with your child occasionally so that your child doesn’t think it’s a forbidden or uncomfortable topic for you to discuss. Point out and appreciate gender diversity in other kids or adults so your child understands that there is a variety of gender identities and expressions, not just two. Most of all, make sure your child knows that if they are teased or questioned excessively about their gender that it is not because there is anything wrong with them, but instead it is because other people don’t understand that there are other ways to be boys, girls, both or neither.

How Do I Choose a Mental Health Provider?

Once you have determined that you will seek a therapist’s support, you must then identify a professional who will be most appropriate for the needs of your child and family. By no means are all therapists well informed on issues of gender as they relate to children and youth. As you seek the services of professionals, ask them what their experience is working with transgender or gender-expansive youth. A bad therapist can do more harm than good.

If you cannot find a qualified therapist in your area, consider finding someone you are comfortable with and who is open to learning; they can then consult with another therapist who has experience around issues related to gender and youth. Contact us for more information.

Ongoing monitoring of the therapy relationship is important. If the therapist is for your child, keep the lines of communication open between you and your child, as well as between you and the therapist. You want to make sure the environment remains supportive and affirming for your child.

Need some help finding a mental health professional? Gender Spectrum has connections to many professionals who are committed to affirmative care and support of gender diverse youth. If you need referrals for medical, mental health, legal or educational support, contact us and we will connect you to professionals who can help you find appropriate referrals.

Legal Considerations

Deciding Whether to Seek Legal Help

Parents of gender-expansive or transgender kids may have some legal considerations to contend with, such as identity documents, health insurance, discrimination, and custody. Many of the legal issues faced by parents with gender-expansive children can be resolved through education and training.

Discrimination: Keep in mind that most institutions have little or no experience responding to gender-expansive or transgender kids. Rather than anything malicious, they may simply be unaware of the challenges being faced by your child, and don’t know how to respond more effectively. Sometimes the easiest and most efficient way to garner the support you seek is to approach the individuals involved directly, armed with the most up-to-date information and laws. If you can’t resolve the issues, you may want to consider seeking legal advice.

Identity Documents: What name should I use to register my child for school? What if I am asked to provide legal documentation that does not match my child’s gender expression? Should I legally change my child’s name and/or gender? While legal name changes give you a great deal of leverage to ensure your child is referred to consistent with their gender identity, some parents are not able or ready to take this step. Many have found it helpful to approach the school, program, agency or organization in which their child is involved and simply request that their child be referred to by their preferred name. There are no laws preventing schools and other organizations from calling children by their chosen name. Much of the time all it takes is a little education to help them understand that it is the right thing to do.

Custody Issues: Many lawyers and judges have no experience with the issues related to gender and children. If your child lives in two households and you are experiencing disagreement about your child’s gender status and what is best for your child, obtain therapy and/or mediation as your first steps. Try to reach an understanding outside of the courtroom about how to proceed with parenting your child. This may mean having to make compromises, especially if your child is young; though perhaps not ideal, it likely preferable to going to court and facing a potentially negative outcome.

If your family is already in the family courts system, you should immediately seek the counsel of an attorney familiar with issues and rights related to gender-expansive and transgender identities. It is also advisable to secure the professional support of doctors and therapists who can speak to the court about gender-expansive and transgender children and what they think is in the best interest of your child with regard to gender expression.

Choosing a Legal Provider

If you are in a situation where you need an attorney, especially for a family law case, it is imperative that you find one that has experience in dealing with gender-expansive or transgender children. There is too much at stake in custody cases to take unjustified risks or an unwise approach to a case based on inexperience. Gender Spectrum can connect you to experienced attorneys who can provide advice to you and/or your attorney around the issues of gender.

Need some help finding an attorney? Gender Spectrum works closely with the National Center for Lesbian Rights, the ACLU, and the Transgender Law Center, as well as other legal advocates who are committed to support of gender diverse youth. If you need referrals for legal support, contact us and we will connect you to professionals who can help you find appropriate referrals.

Photo credit: Timothy Krause